We are following a 34-year-old female, who presented in the last 4 years recurrent episodes of (metabolic?) encephalopathy (with confusional state, asterixis; EEG showed triphasic waves) lasting for about 2 weeks. In some occasions, these state were associated with hyperammonemia or hyperlipasemia. She has also hypogonadism and achantosis nigricans (at both hands) (please, see photos). Her parents are not consanguineous. His father also presents achantosis nigricans at both hands, but he works as farmer.
Given the medical history, the following conditions should be seriously considered: tumors of the ovary (including polycystic ovary), liver, pancreas, kidney and adrenals; infection of liver, gall bladder, kidney and pancreas; autoimmune disorders; genetic disorders; obesity associated metabolic panel; lymphoma and cancers of genitor-urinary tract. Hope this helps. Take care!
The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.